- Molina Healthcare (Houston, TX)
- …and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina Healthcare ... members. + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests additional information… more
- Texas Health Resources (Dallas, TX)
- **RN Nurse Clinician - Forensic Health** _Bring your passion to Texas Health so we are Better + Together_ **Work location:** Office at Texas Health Dallas and will ... required + RN upon hire required and + BCLS prior to providing independent patient care and maintained quarterly...**What You Will Do** The Forensic Nurse Examiner (FNE) Clinician II job position supports the Texas Health Forensic… more
- UTMB Health (Galveston, TX)
- Operating Room Nurse Clinician III - Galveston **Galveston, Texas, United States** **New** Nursing & Care Management UTMB Health Requisition # 2504011 **Minimum ... permit to practice in Texas. Current BLS required. **JOB SUMMARY:** Competent Clinician . Possesses knowledge and skill to meet standards for competent professional… more
- UTMB Health (League City, TX)
- Operating Room Nurse Clinician III - Victory Lakes (Casual Appointment/ 11a - 11p) **League City, Texas, United States** Nursing & Care Management UTMB Health ... permit to practice in Texas. Current BLS required. **JOB SUMMARY:** Competent Clinician . Possesses knowledge and skill to meet standards for competent professional… more
- Molina Healthcare (Fort Worth, TX)
- …and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina Healthcare ... members. + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests additional information… more
- Molina Healthcare (Dallas, TX)
- …financial responsibility for Molina Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed. + Processes requests ... **Preferred Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
- Molina Healthcare (Houston, TX)
- …financial responsibility for Molina Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed. + Processes requests ... within required timelines. + Refers appropriate cases to Medical Directors and presents them in a consistent and efficient manner. + Requests additional information from members or providers in consistent and efficient manner. + Makes appropriate referrals to… more
- Centene Corporation (San Antonio, TX)
- …to ensure level of care and services are medically appropriate + Performs prior authorization reviews related to mental health and substance abuse to determine ... medical appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of member, treatment needs, and discharge planning + Analyzes BH member data to improve… more
- Molina Healthcare (Fort Worth, TX)
- …to Molina members with ASD and other related disorders. * Approves prior authorization requests for BHT treatment by reviewing Behavioral Health Therapy (BHT) ... assessments and treatment plans for medical necessity and BHT best practice guidelines. This includes but is not limited to: Psychological Evaluation requests, Comprehensive Diagnostic Evaluations, Functional Behavioral Assessments, and Progress Reports. *… more
- Veterans Affairs, Veterans Health Administration (Amarillo, TX)
- …a highly qualified candidate. Responsibilities The HBPC Medical Director is the senior clinician and is responsible for the overall medical care delivered by the ... GEC Service line. In addition to their role as clinician , the HBPC Medical Director will have administrative responsibilities...subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested… more